Moe Cathrine, Brinchmann Berit Støre
Faculty of Nursing and Health Sciences, Nord University, Bodø, Norway.
Nordland Hospital Trust, Bodø, Norway.
Health Soc Care Community. 2018 Jan;26(1):113-121. doi: 10.1111/hsc.12471. Epub 2017 Jun 27.
Reablement is an interprofessional, home-based rehabilitation service that aims to enable senior residents to cope with everyday life and to prevent functional impairments. Systematic accounts of what practitioners actually do when establishing reablement are lacking. This study aims to generate a grounded theory of practitioners' patterns of action when establishing reablement. The study is located in Norway, and grounded theory is the methodological approach. Data were collected from January 2014 to August 2016 through participant observations, focus group interviews and individual interviews. Informants are municipal healthcare employees in different organisational areas associated with the process of establishing reablement services (managers of conventional home care and representatives from the administration and service-provider offices). Altogether, 17 individuals are interviewed. The empirical data are analysed several times using open, selective and theoretical coding. The grounded theory, "tailoring reablement," includes three phases-replicating, adapting and establishing-and the strategies of collaborating, developing knowledge, habituating and filtering. The theory of tailoring reablement also includes the impact of the contextual factors. The study seeks to bridge the gap between research and practice. The theory of tailoring reablement emerges from an inductive approach and theorises participants' actions. The theory focuses on the phases from innovation to implementation. Establishing a new service model in a complex welfare setting requires a wide range of actors and agencies. Tailoring reablement also requires flexibility and professional autonomy. It is important to create terms and conditions for this within a stringent health and care service. The insights of this study have implications for practice development of reablement and can fit other public sector fields.
康复赋能是一项跨专业的、基于家庭的康复服务,旨在使老年居民能够应对日常生活并预防功能障碍。目前缺乏对从业者在开展康复赋能时实际所做工作的系统描述。本研究旨在构建一种关于从业者在开展康复赋能时的行动模式的扎根理论。该研究位于挪威,采用扎根理论作为方法论。数据收集于2014年1月至2016年8月,通过参与观察、焦点小组访谈和个人访谈进行。受访者是与康复赋能服务建立过程相关的不同组织领域的市政医疗保健员工(传统家庭护理经理以及行政和服务提供办公室的代表)。总共采访了17个人。实证数据通过开放式、选择性和理论性编码进行了多次分析。扎根理论“定制康复赋能”包括三个阶段——复制、调整和确立——以及协作、发展知识、习惯化和筛选等策略。定制康复赋能理论还包括情境因素的影响。该研究旨在弥合研究与实践之间的差距。定制康复赋能理论源于归纳法,并对参与者的行动进行了理论化。该理论关注从创新到实施的各个阶段。在复杂的福利环境中建立新的服务模式需要广泛的行为者和机构。定制康复赋能还需要灵活性和专业自主权。在严格的健康和护理服务中为此创造条件很重要。本研究的见解对康复赋能的实践发展具有启示意义,并且适用于其他公共部门领域。